Critical Access - Ramps

Ramping up residential access

Imagine an individual with a debilitating injury that requires the use of a wheelchair or walker. The person enters a rehabilitation center. After a few days, the insurance company decides there is no further progress to be made at the rehab center and decides to stop payment. With little time available, the individual and/or case manager tries to have a ramp installed at the patient’s home. But the landlord has no interest in building a ramp. Or the bank says ‘no’ for a ramp loan because it only lends to homeowners and the patient is a renter, as are most folks with disabilities. Or the soonest a contractor is available to take on such a small project is six months. What happens? Chances are the person goes home, anyway.

Friends and relatives must carry the patient in and out of the residence, up and down stairs, risking further injury to the patient or the friend/relative. If friends and relatives are unavailable, the patient begins missing medical and rehabilitation appointments, cannot get to the store, is unable to get out into the community and becomes increasingly isolated. And if patients need treatments several times weekly, like dialysis, and are unable to leave their homes, the results can be a matter of life or death: all because of the lack of a simple structure—a ramp. “How can you have a life if you cannot get out the front door,” asked Alpha One Project Manager Brad Strause. “It is the key to continuing rehab, to regain as much function as possible, to maintain community and personal ties, to be able to shop for food or get a job.” And so was born the idea of Alpha One’s “Critical Access” program, designed to make ramps affordable and readily available to Mainers with disabilities.

Background
When he first joined Alpha One nine years ago, one of the initial things Strause noted was the difficulty clients had obtaining ramps. Sometimes it was a matter of money. Other times it was finding contractors. Those fortunate enough to already have one had problems taking the ramp, which was usually cemented to the ground, with them if they moved to another location, meaning they had to go through the whole process of obtaining a new structure. Strause worked at a wood-fabricating plant in his youth and noticed the similarities between the pallets he manufactured then and the ramps he saw at clients’ homes. He reasoned that, like many wood products, ramps could be manufactured in sections that could be stored, transported and eventually assembled elsewhere. Like most good ideas, someone else has usually thought of some- thing similar and perhaps tried it elsewhere.

Thanks Minnesota
Sure enough, Strause checked around and discovered Minnesota’s State Independent Living Council had joined forces with the Department of Rehabilitation, vocational rehab agencies, United Way and an engineering firm to develop an almost-identical plan. In fact, the Minnesota groups had already begun manufacturing ramp sections and building the structures as funds became available. The pieces of the pressure-treated-lumber Minnesota design were easily bolted together and, since the units were not ce- mented into the ground, could be disassembled and moved to a new location if the individual moved. Because the ramp was moveable, Strause reasoned, lenders might consider more liberal financing arrangements with renters, using the ramp itself as collateral rather than requiring that the buyer own the property where the ramp would be located. M-Power was one of the first Maine financial groups to step forward and agree to finance several ramps for renters. Other agencies, such as the Maine State Housing Authority, have followed suit.

Quality control With a ramp design that provided instructions on pitch and railings—but still without a fabricating center where it could mass produce ramp sections—Critical Access organizers found that contractors wandered from the original plans. Consequently, they often built ramps incorrectly. To ensure they were built properly, Strause decided having one or two dedicated crews to specialize in ramp construction using pre-fabricated materials was the best way to go. The state Department of Economic and Community Development (DCED) and federal Housing and Urban Development — which invite suggestions on how to spend federal community block-grant funds — saw the need for the ramp program and agreed to help develop a fabrication area where ramp components could be manufactured in sections and train contractors to properly install the structures. Together with Strause, they developed a pilot program to see if the components could be built off-site, transported to a storage area and then taken to a site where trained contractors would reassemble them. AmeriCorps and Youthbuild of Lewiston became involved and built eight ramps. DCED kicked in enough money to build another dozen and the Maine State Housing Authority dedicated funds for another six. “We found a good, reliable professional builder in Southern Maine that manufactured the prefabricated sections and began installing them,” Strause said. “The more they built, the faster they got. Now builders can put one up in a day or so. We even sent a builder to inspect the operation in Minneapolis, where they have built and installed more than 3,000 ramps over the past dozen years.”

State ups the ante
The state wants to be more invested in the program and has offered funding to build and install 50 ramps statewide this year and another 100 next year,
Strause said. The fabrication plant will remain in Southern Maine. Plans are to develop Critical Access centers in Bangor and Presque Isle. Ramp components will be manufactured at the Southern Maine facility and components for 10 to 15 ramps shipped to and inventoried at sites in the Central and Northern Maine communities Critical Access is soliciting applications from qualified builders in those areas, will select one from each area and then bring them to the Southern Maine fabrication site to receive training on ramp components, disability awareness and applicable build- ing codes. The first of the 50 ramps scheduled for construction in 2007 will hopefully be online sometime this July. Determining who will receive a ramp will be the job of Alpha One staffers who, as part of their independent-living evaluation, will determine who should receive the ramps. The income-based program will cater to low- and moderate-income clients, The Alpha One staffers will contact the builder, who will set up a time with the client to deliver and construct the ramp. On the day of installation, the builder will collect the components, go to the site and build it. “Our goal is to make that all happen within two weeks,” Strause said.

Users happy
Ronald Abbott, 78, built a ramp 10 years ago at his Sanford home. Unfortunately, the ramp was rotting away quickly and in danger of no longer handling his wheelchair. Through his muscular dystrophy support group he was referred to an Alpha One staffer who helped him obtain funding for a Critical Access ramp. In less than three days, the crew dismantled his old ramp, built the new one and carried the old materials away. “I’m thrilled with it,” he said. “Without the ramp I would be totally homebound.” Nora Parady, 52, of Acton was in the hospital last October recovering from a knee replacement that added to her breathing problems. She lived in a home with steep stairs and rotting railings that sometimes required her to crawl to gain access to her front door. Before she left the hospital, a Critical Access crew assembled a new ramp at her home. “Having the ramp has been a godsend,” she said. “When I was rehabbing, I was able to get outside for a walk on nice days. That helped significantly with my recovery.” Such a simple structure, such huge benefits.